There are an estimated one and a half million people in the United States today that have special, personal hygiene problems (such as changing dressings, etc.) due to ostomies or the like. An ostomy is a general term referring to any operation in which an artificial opening is formed between one or more hollow organs and the abdominal wall for discharge of intestinal contents or of urine. These operations are performed because of gastrointestinal, urological or proctological problems arising from disorders such as cancer, spinal cord injury, cerebral palsy, multiple sclerosis, colitis, ulcers, etc. The patients utilize special collecting appliances in the form of a pouch that is attached to the stoma or mouth of the opening and which must be carefully and frequently changed.
There are also an estimated one million people that suffer bowel and bladder dysfunction as a result of paralysis from accidents or diseases affecting the spinal cord. These people and others may utilize special equipment in the form of catheters, drainage bags, suppositories, and enemas in order to stimulate discharge or to collect uncontrollable discharge.
Fortunately, most of these two and a half million people suffering from this type of problem are independent in caring for themselves. However, there are many who cannot do this because of one basic problem--visualizing either the urogenital area, the anus, or the stoma which is usually located low on the abdominal wall. This problem may arise because of a protruding abdomen, wrinkled or folded skin, large breasts, inability to flex the spine, weakness in maintaining certain positions, poor balance, etc. Any of these may be such a handicap that the patient must have assistance in performing his very personal functions and hygiene routine. Cleanliness is very important to minimize the chance of infection and skin irritations and is very difficult when the area cannot be seen.
Visibility is most important in using toileting equipment because many patients have decreased sensation and cannot simply feel what they must do. Due to the nature of their affliction, many people who use special equipment for toileting are unable to stand and therefore cannot utilize a wall mirror if one is available. Hand mirrors help with visibility but eliminate the use of one hand. Supine or side lying positions are often recommended for changing an applicance or inserting a suppository since these are stable positions that allow the person to relax and gravity to act on the abdomen and its contents, thus affording a cleaner and therefore safer procedure. However, these positions also afford poor visibility.